What are trigger points?

A trigger point is simply a hardened band within the muscle on which there is a zone of intense pain. The hardened band or taut band may feel like a pea buried deep in the muscle. It maintains a hard contraction on the muscle fibers connected to it, thus causing a tight band that can also be felt in the muscle.These trigger points in muscles can result in restrictions on movements – for example the neck may not be able to turn freely and fully.

What is the best way to release trigger points?

There are few ways to treat trigger points i.e. by injections or by applying non-invasive ischemic pressure.  

Probably the easiest and one of the most effective is simple physical pressure applied to the trigger point itself. Injections has obvious drawback. We prefer applying digital and employ special stretching techniques and release method to the most appropriate spot or meridians points to achieve better results. This method is extremely safe and effective way to deactivate trigger points.
Trigger Point Injection.

Trigger point / myofascial pain

When trigger points develop, a person will experience pain, since pain usually develops after muscle hardening.The pain can be a mild ache. it can also be an intense pain. It can be localised to the site of the muscle hardening. It can also be felt in another part of the body – a condition called referred pain.

What does this referred pain feel like?

Referred pain caused by trigger points is usually steady, dull and aching. It is often a deep pain. It may occur at rest, or only on movement. The intensity of this pain varies from mild discomfort to severe and incapacitating pain.Myofascial trigger point therapy is therefore aimed at bringing about pain relief by using specific myofascial treatments or myotherapy to inactivate myofascial trigger points.

Are trigger points the same as a muscle spasm, strain or tear?

No, a trigger point is not the same as a muscle spasm. A spasm involves a violent contraction of the whole muscle. A strain or tear involves physical damage to the muscle or tendon fibres.In contrast, a trigger point is a contraction or hardening in only a small part of a muscle.

Are Trigger points common?

Myofascial trigger points are among the most common – yet often neglected and inadequately managed – causes of musculoskeletal pain seen in medical practice.Unfortunately, many general practitioners do not know about trigger points, as trigger points do not show on X-rays or scans.A healthcare professional trained in myofascial trigger point massage therapy, however, can perform trigger point examination to spot tenderness and the taut band by palpation, to reproduce the patient’s pain. Other symptoms of myofascial trigger point may include limited range of motion, weakness of certain muscles, depression and sleep disturbance.

Most patients who have had a stable pattern of myofascial pain pattern for months or longer are likely to respond positively to treatment. Plus, the person who receives a trigger point therapy should feel much better, both in terms of pain relief as well as freer, greater range of motion.Plus, the person who receives trigger point massage therapy should feel much better, both in terms of pain relief as well as freer, greater range of motion.

How does trigger point massage therapy work?

The therapy works in three ways:

·         Trigger point massage therapy breaks into the self-sustaining vicious circle that has kept the muscle contracted.

·         Trigger point massage therapy increases the circulation, which has been restricted in the immediate area by the contracted fibres, thus enabling oxygen and nutrients to flow to the spot.

·         Trigger point massage therapy directly stretches the trigger point's knotted muscle fibres.

What follow-up treatment do patients require?

Patients who have received trigger point massage therapy are encouraged to:

• Continue with trigger point massage therapy until they experience complete relief of their pain and other symptoms.Perform physical exercise within their capability – but refrain from strenous exercises that “push the limits”.
• Observe a proper, nutritious diet.
• Address stress factors such as those associated with work or family. Reducing stress will decrease muscle tension.
• Perform the prescribed self-stretches for therapeutic purposes.
• Maintain a good, balanced posture.

Do i have to undress for Trigger Point Therapy?

No, all work can be done with the patient's clothes on. You are encouraged to wear loose-fitting, comfortable clothing. Gowns are provided for treatment.

Do the treatment involved manipulation or "adjustment"?

No. You do not have to be adjusted or manipulated. We integrate evidence-based techniques release relief pain or tension with your spine.

Is the treatment painful?

Yes. Most active trigger points are sensitive to pressure. We can  always work within your pain tolerance. Most patients describe the pain as a "good" type of pain.

Is there anything more that you need to do after trigger point massage therapy has relieved the pain symptoms?

Yes. After a session of trigger point massage therapy, it is VERY important to:

Apply a hot pack covered with a dampened flannel or towel to the treated area for a few minutes.

Gradually and gently stretch the treated muscle through its full range of movement three times, with a pause to breathe deeply and consciously relax between each cycle.

How to avoid a recurrence and achieve lasting recovery?

The following pointers can help you achieve lasting pain relief from trigger point massage therapy, and avoid a recurrence of trigger points:

Learn to respect your muscles. Your muscles were not designed to be held for long periods in a sustained contraction or in a fixed position. Vary your tasks each day. If you need to lift heavy objects, do so very carefully.

Slow your working pace, and take short rests frequently, especially if you feel muscle fatigue.

• Do a daily programme of passive stretches that puts the affected muscles through a full range of movement, and repeat the stretches throughout the day. Be like the cat – it rarely tries to walk after a sleep without first stretching smoothly and slowly.
• Massage any trigger points up to a dozen times a day, for a minute at a time, as described above.
• Learn relaxation techniques.
• Always watch your posture when sitting, reading, using the computer car or phone. Don't stay too long in any one position.
• Observe what postures, movements and activities stir up your trigger points. If you don't have to do that activity, then don't. If you do, then modify they way done – for example, by using the other hand.
• Avoid getting the muscles cold, by wearing an extra warm layer of clothing, and adjusting heating etc.
• Correct any imbalances in your diet, and take vitamin and mineral supplements as recommended by your health practitioner.

What about exercise?

Exercise should be regarded as a prescription, and the kind of exercise prescribed by your trigger point massage practitioner depends largely on how active your trigger points are at that time.

Once the trigger points are inactivated and constant rest pain fades, then a carefully graded exercise programme is needed to increase muscle endurance and strength.

This involves muscle lengthening exercises before working up to shortening exercises. Post-exercise soreness and stiffness should not last longer than three days. If they do, the programme needs to be altered.Then, a regular conditioning programme – such as swimming or cycling – is recommended, at least twice a week.

Would the trigger points get better if you just rested up?

Yes and no.Studies have shown that with a short period of rest and the avoidance of whatever activated the trigger point, the pain symptoms may disappear over a few weeks. This makes people believe their problems have gone away.But, if you examine the muscle properly you will find that it is still tight, stiff and weak, and still tender when pressed on. In other words, the trigger points are still there; they are just lying dormant and not causing referred pain at that time.The bad news is that they can be very easily reactivated to cause pain again, by acutely overloading the muscle in a new or repetitive task, working or sleeping in an awkward position, chilling the muscle, or during emotional stress, fatigue, or viral infections. Trigger point massage therapy is needed for trigger points to be effectively released.

What does it takes to reactivate a latent trigger point?

This will depend on the degree of muscle conditioning, so keeping fit can help reduce the likelihood of it happening.The only way to get rid of trigger points for lasting relief is through actively hunting out and treating all the active and latent trigger points. A skilled trigger point massage therapist will be able to do a thorough job of this.

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